'Think Hard' Episode #28: Our Patron Saint

How is talking to a public audience about philosophy different than speaking to those in traditional academic settings? What do philosophers have to offer the public?

In the latest episode of my podcast Think Hard #28: Our Patron Saint welcome special guest Dr. Jack Russell Weinstein, Director of the Institute for Philosophy in Public Life at the University of North Dakota and host of the public radio show and podcast Why? Philosophical Discussions About Everyday Life, to talk about public philosophy.

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Learn more about Think Hard, and listen to all our episodes at our website thinkhardpodcast.com, or find us on Apple Podcasts or Stitcher. Follow us on Twitter, follow our Facebook page, and join our Facebook Community Group to connect with José Muñiz, Danielle LaSusa, and fans of the show.

Practical Philosophy for Veterinary Medicine

A philosophical perspective can help with almost any professional work, including veterinary medicine. Last week, I spoke with professional veterinarians at the Early Career Professional and Personal Development Program for the Portland Veterinary Medical Association about how philosophical skills and thinking can help make their work more efficient, productive, purposeful, and fulfilling. Here are some of the tips and perspectives I gave them.

Philosophical Perspectives for Veterinary Care

There are lots of ways that a philosophical approach may serve the professional and personal development of those in the veterinary field. Here are just a few of the areas where a philosophical perspective may be useful:

Relationships with Colleagues

As with most professions, veterinary work may require that you work with or alongside other practitioners and staff, and you may not always agree with the approaches, values, or worldviews of your colleagues, leading to frustration and conflict.

Practical Philosopher’s Tip:

One of the major philosophical skills is being able to inhabit, understand, and evaluate a variety of worldviews—without necessarily condoning or agreeing with those perspectives. This skill allows you to understand and work more effectively with colleagues and contribute to a more productive, collaborative, and congenial workplace. Here are some tips for how:

• Approach other perspectives with a fair and charitable attitude, trying to see them in their strongest possible light, rather than purposefully representing them as weak and flawed;

• Temper your own emotional reactivity, egocentrism, and self-righteousness in the face of opposing points of view. Listen attentively and with an open mind;

• Analyze, evaluate, and judge other perspectives with precision, accuracy, and care;

• Evaluate, revise, and refine your own assumptions and judgments so that you can grow both personally and professionally.

Ethical Decision-Making

Veterinarians face certain kinds of ethical decisions on a regular basis that doctors in other fields deal with far less frequently, if at all. Examples include weighing conflicting needs and desires of both the client and the patient in medical decisions; and considering the moral impact of euthanasia in a variety of unique cases.

Practical Philosopher’s Tip:

The philosophical subfield of ethics has an enormous body of literature devoted entirely to how to figure out the right thing to do. Of course, there are lots of different perspectives and guidelines out there. Here are some tips for how to navigate sticky ethical situations:

• Understand and reflect on your professional code of ethics, which may serve as a guidepost for when things are unclear. If you do not have a professional ethics code, or you feel it is too vague or incomplete, and/or it conflicts with your personal code of ethics, devote some time to sorting this out, perhaps with the help of a professional philosopher/ethicist;

• Moral decision-making is complex and nuanced; there is likely not a one-size-fits-all answer for every situation;

• You will not get it right every time, but this does not mean that you are a moral failure. Keep in mind Aristotle’s idea that moral intelligence and character is built over time, with habitual practice.

Empathy Fatigue

Veterinary work involves repeated exposure to and relationships with creatures in critical need. The impact of this exposure to trauma can lead to a kind of fatigue in compassion or empathy.

Practical Philosopher’s Tip:

Philosopher Rita Manning believes that a caring relationship with others should guide our actions, but acknowledges the reality of “caring burnout.” She argues that caring for oneself is part of our moral obligation. Here are some ways to avoid and/or respond to “caring burnout”:

• Put on your own oxygen mask first. Care for others is not possible if you deplete your means or capacity to do so; thus, prioritize your physical and psychological needs if you wish to be an agent of care. This may mean making or asking for changes in your life or workplace.

• Remaining open and present in others’ suffering does not require you to suffer as well. The ancient philosopher Epictetus said, when you see someone suffering, “sympathize with him so far as words go, and, if occasion offers, even to groan with him; but be careful not to groan also in the center of your being.”

• Pay close attention to your body when dealing with emotional situations. What is happening to your pulse your breath, your jaw, your stomach? Your peripheral awareness of these aspects can help you stay grounded, centered, and prevent you from getting swept away with emotion.

Parenthood

The average American workplace is not currently organized to serve and support working parents, particularly in highly demanding fields, such as medicine. In a field dominated by women, such as veterinary medicine, this concern may be elevated, as women statistically continue to do the majority of child care, especially in the early stages of a child’s life.

In addition, the transition to parenthood can bring massive shifts in one’s sense of identity, priorities, values, and psychological vulnerability, leading to confusion and struggle, both at work and at home.

Practical Philosopher’s Tip:

The work of parenting is unpaid and largely undervalued in our culture. This does not mean that it is not strenuous, challenging, and extraordinarily important, both for our personal lives and for society at large. Here are some tips for navigating working parenthood:

• What feels like “you” problem is often part of a larger structural problem. This acknowledgment may not immediately help solve the problem, but it can help guide where improvements should be made and remove some of the burden of feeling like it is personal failing;

• Emphasize self-compassion, humor, and flexibility. Parenthood by its very nature involves uncertainty, loss of control, and mistakes;

• Give yourself time to develop and grow into this new identity, along with the changes it brings. The birth of a child is also the birth of a parent.

Work with Me

These are just a few of the many ways that a philosophical perspective may serve you. If you would like more philosophical guidance or training in any of these areas, either in an individual or group setting, I invite you to connect with me.

I offer one-on-one Philosophical Coaching (with a specialization in serving mothers), as well as Ethics Workshops, and other Practical Philosophy Workshops in a variety of areas—including Buddhist mindfulness, existentialism, critical thinking, motherhood and more—for both individuals and organizations.

Contact me and learn more at daniellelasusa.com.

Buddhist Wisdom for Everyday Living — Take the Workshop

Buddhist Philosophy for Everyday Living — Take the Workshop

I'm teaming up with Curious Soul Philosophy this May to lead a workshop called Buddhist Wisdom for Everyday Living. If you are local to Portland, Oregon, join me to learn and discuss the foundational philosophical ideas of Buddhism and see how they may serve us in our everyday lives.

We'll consider the complex nature of suffering, our relationship to the interconnectedness of all beings, and the path for achieving inner peace. We'll also learn a few simple meditation and mindfulness practices that may bring a bit of peace and calm to our day-to-day living.

Where:
World Cup Coffee, 1740 NW Glisan St., Portland, OR

When:
Saturdays, May 5, 12, 18, 2018, 1:00-3:00

Let Suffering Speak

Let Suffering Speak

German-Jewish intellectual Theodor W. Adorno fled the Nazi Holocaust, so he knows a thing or two about suffering.

For much of his career, Adorno wrote about how morality, truth, and meaning are even possible after Auschwitz. In his 1966 Negative Dialectics, he determined that:

“The need to let suffering speak is a condition of all truth.”

Unlike many other philosophers who see "truth" as the correspondence between what we believe and what is real, Adorno sees "truth" as understanding and speaking about the economic, social, political, and historical forces in the world. Suffering—which is inevitable for all of us—is a central part of this truth. 

Although it is certainly unpleasant, suffering is perhaps one of the most informative and important parts of the human experience. Sitting with this pain—whether it be our own or someone else's—takes courage, strength, and compassion. It is extraordinarily difficult, but it allows us to get to the heart of what is really happening, both in society at large and in our personal inner lives.

If we really want to know ourselves and our world—if we want to peel back the layers and see the truth of our inner most fears, desires, dreams, and disappointments—and if we want to act with wisdom and effectiveness, we need to allow suffering to speak.

What suffering speaks truth in you? I invite you to contact me by email or phone, join my mailing list, and connect with me on Facebook, Twitter, LinkedIn, and Medium.

'Think Hard' Episode #23: Hope in a Godless World

For those who don’t believe in a benevolent, higher power, where do we look for hope and guidance when things are looking grim?

In the latest episode of Think Hard #23: Hope in a Godless World, we bring you the audio from a public lecture that I gave to Sunday Assembly Portland. Afterward, my co-host José gets a chance to ask questions and challenge some ideas. And as always, we end with recommendations in our What We're Thinking About segment. Take a listen!

Learn more about Think Hard, and listen to all our episodes at our website thinkhardpodcast.com, or find us on Apple Podcasts or Stitcher. Follow us on Twitter, follow our Facebook page, and join our Facebook Community Group to connect with José Muñiz, Danielle LaSusa, and fans of the show.

Hope in a Godless World

There are so many reasons to feel overwhelmed, and even hopeless, these days. For those who don't believe in an all-knowing, benevolent higher power that has a plan for it all, where are we to look for hope?

In January, I was the Featured Speaker the secular congregation at Sunday Assembly Portland, one of the 70+ Sunday Assembly chapters around the globe, devoted to creating non-religious community that celebrates life.

My talk, which at certain moments, feels more like a philosophical sermon, is called "Hope in a Godless World." I talk about how to choose and cultivate hope, even when you don't have the foundations of religious faith to guide you. I hope you listen and feel inspired!

If you would like to know and share more about different ways to think about hope, meaning, purpose, and the affirmation of the human spirit, send me an email, subscribe to my newsletter, and listen to my podcast Think Hard.

We ourselves must walk the path

Guatama Buddha's great teaching was how to become free from the cravings, fears, and ego-filled pride that keeps us all miserable. He offered a clear path for how to achieve this enlightened state. But he also said that no one can save us but ourselves. "We ourselves must walk the path," is the translation often given.

So maybe you're not aiming for nirvana, but the same is true for any kind of healing and self-actualization that you strive to do. You must do the hard work of looking inside, reflecting, and sitting with discomfort, to achieve the rewards of greater inner clarity, integrity, and power. 

While the path is ultimately yours to walk, you don't have to walk it alone. It is wise to find guidance and help from those who offer. If you would like help walking your own path, I invite you to connect with me at daniellelasusa.com.

I Had Postpartum Psychosis

Two years ago today, my husband helped me check myself into a psych hospital with symptoms of mania, severe insomnia, panic attacks, and racing and delusional thoughts. Our daughter was three months old.

With no previous history of mental illness, I was suddenly suffering from postpartum psychosis—a condition that affects more than 40,000 women a year.

You can read more of my story in a non-fiction piece published at Literary Mama called "White Noise." Or, you can watch me read it in the video below.

In a culture that offers paltry support to new parents and stigmatizes mental illness, millions of women with postpartum depression, anxiety, OCD, PTSD, psychosis, and other perinatal mood disorders suffer in isolation and shame.

One place that I found help was Baby Blues Connection, a non-profit organization located in Portland, OR, dedicated to offering support and resources for families struggling with perinatal mood disorders. Postpartum Support International also offers excellent information and resources.

Mental illness can feel dark and scary, especially in a time with a new baby, when you expect to feel overwhelmed with love and joy. If you, or someone you know is struggling with pregnancy or postpartum mental health, know that you are not alone.

I now offer support to mothers as a Philosophical Coach because I saw such a need to help women during this time. Even without mental health complications, the transition to motherhood can be so incredibly challenging—from missing your pre-baby life, to losing connection with your partner or friends, to struggling to accept and even to dress your new mom body.

If you would like to have a conversation about your transition to motherhood, and to integrate your intellectual and creative sides with the physical and deeply emotional experiences of motherhood to create an identity as a mother that feels powerful and whole, please contact me or see my page for moms.

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Danielle LaSusa Ph.D. is a Philosophical Coach and Consultant. She helps new moms grapple with what it means to make a person. She is the co-creater and co-host of Think Hard podcast, which brings fun, accessible, philosophical thinking to the real world.

© Copyright Danielle LaSusa PhD, LCC, 2018. All rights reserved.

My Upcoming TEDx Talk

My Upcoming TEDx Talk

I'll be giving a TEDx talk at TEDx PCC, in Portland, OR, on April 19th! The theme of the event is Collective Genius.

I've wanted to give a TEDx talk pretty much ever since I found out they existed nearly 10 years ago, so it is an incredible personal and professional thrill to have the opportunity to give one. The content of the talk is still in development, so I don't want to give too much away yet, but I am working hard on it, and I am so excited to share it with you!

TEDx PCC is open to the public. Tickets will be available February 19th at tedxpcc.com.

How to Make Things Beautiful

On the dawn of 2018, I bring you a quote from philosopher Friedrich Nietzsche, who was expressing his deepest desire for the new year of his time. In his 1882 work, The Gay Science, Nietzsche says:

For the new year...On this day, all allow themselves to express their wish and their most beloved thought. So I too want to say what I wished for from myself today, and what thought first ran across my heart this year—what thought shall be for me the ground, guarantee, and sweetness of all further life! I want to learn more and more to see as beautiful what is necessary in things—in this way I will be one of those who make things beautiful...to sum it up: some day I want to be only a Yes-sayer!

We have great power to change and influence many things, both in ourselves and in this world, and working toward positive changes is admirable and important. But for those things that we cannot change, we still have the power to see beauty, even in the ugly and tragic. In saying "Yes!" to the world as it is and must be, we free ourselves from unnecessary suffering, and as Nietzsche says, we become one of those who make things beautiful.

A Choice in the Making

For 20th century French existentialist Jean-Paul Sartre, we humans have the power to determine who we are. Every moment, we are creating ourselves through our choices, both in actions we take and in the meaning that we ascribe to those actions. And no matter our circumstances, we are always free to choose differently—to choose new ideas, beliefs, thoughts, and actions.

In some ways, this can be scary. It comes with a lot of responsibility that we may not always want. But it also means that we are our own makers. We write our own rules. We determine our own paths.

In short, your human life is the ultimate creative act.

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Danielle LaSusa Ph.D. is a Philosophical Coach and Consultant, helping individuals and organizations think clearly, choose wisely, and live purposefully. She is the co-creater and co-host of Think Hard podcast, which brings fun, accessible, philosophical thinking to the real world.

The Confidence to Consider

I had a text exchange recently with a friend who was grew up with a conservative Christian upbringing, but has since left the church and stopped believing. She was reluctant to watch a video that her uncle gifted to her, (likely in a passive-aggressive attempt to bring her back into the fold), which ostensibly made a case for everything from the Biblical great flood to the Christian resurrection, based on archeological artifacts and other kinds of data.

"I struggle with that sort of thing," she said. "Like: what if that evidence was in any way legit or convincing? I'm not sure I could be convinced to revisit my conclusions at this point."

My friend had gone through a rather dramatic break with her religious faith and didn't want to re-open that wound, or to find herself swayed to return. It would be too disruptive to an identity and belief structure that she had worked hard to rebuild.

That got me thinking. So many of us struggle with political or religious discourse with people who don't agree with us because we are afraid of the kind of fundamental changes to our beliefs and identities that such talks may bring. Maybe we don't feel confident in our own positions because they are new, or because we've never really thought about them in a deep way before. Maybe we are afraid of being manipulated or hoodwinked, and finding ourselves confused, lost, not knowing who we are or what we believe.

Trusting our own critical thinking skills and our ability to make good decisions, and having the confidence that we will find our way, is essential to have open and civil dialogues with people who disagree with us. If we're afraid of being manipulated, then we won't listen. We need to work to build our thinking and reasoning skills. We need to have the confidence to consider.

The Sorry State of Describing Motherhood

I'm reading What Mothers Do by Naomi Stadlen and reflecting on her point that motherhood and mothering is now described in language more so than ever before--in books and online rather than through nonverbal communication in multigenerational families, as it was in years past--and yet there is such a lack of both words and stories that communicate the activities of mothering. (There are tons of stories about romantic love in our culture, but when was the last time you saw a movie about maternal love?) In particular, there is a lack of positive and non-punitive words to describe motherhood. It's no wonder that new moms can feel so lonely and displaced. We literally don't even have the words to describe what we're doing. I went to a "Baby and Me" yoga class when my daughter was a couple months old, the yoga instructor, God bless her, made a practice of holding and soothing fussy babies so that their mothers could get a few more uninterrupted minutes of downward facing dog.  As Laura rocked and bounced with my baby in her arms, she said,  "If I can make it so you have to put your baby to sleep one less time today, it's a good thing."  It suddenly occurred to me that, in fact, that's what all that rocking and bouncing and shooshing was often about: putting my baby to sleep.  It just felt like a constant state of foggy, sleep-deprived being.  I had come to believe that this was just who I was now: a bouncing boob in a haze of white noise. "When you're bouncing on that yoga ball and shooshing your baby, you're doing work," Laura said. "You are putting your baby to sleep, and that is a job."  It was a revelation.

Stadlen cites a lullaby from a collection called Weavers of the Songs: the oral poetry of Arab women in Israel and the West Bank that is all about trying to rock her baby to sleep. But the baby won't sleep so she passes him off to her brother's wife. And the song is sung again, and passed off to the next person, and the next. How little information and communication of motherhood we have in contemporary American and European culture. The mere existence of a lullaby about how damn hard it is to get a baby to sleep would be such a comfort, let alone other people around to whom we could pass the fussing baby.  How did we get here?  How do we let so many women suffer in such physical and psychological isolation? Telling stories and writing songs about how hard motherhood is would go a long way toward helping new mothers feel less alone.

No Birth Plan Ever Survives Contact with the Enemy

As soon as I learned what an episiotomy was, I knew I didn't want one. For the uninitiated, an episiotomy is a procedure done to help make room for a baby during delivery, by making an incision in the perineum, the tissue between the vagina and the anus.

Yeah, that's why I didn't want one.

In fact, when I filled out the intake form on my childbirth class, I wrote it down as one of my biggest fears. But, in the immortal words of Mick Jagger, you can’t always get what you want.

My "birth plan" was to do an unmedicated, all natural birth, with as few interventions as possible. I wanted to experience the surge of hormones, to prove that I had the grit, to commune with my maternal ancestors who I imagined were screaming and squatting in fields and log cabins.  I talked with friends who had done it au natural, who said that the experience made them feel strong and powerful, and who told me to be aware of the "ring of fire", (the bit when the dreaded episiotomy might happen).

My husband and I had taken all the birthing classes, and my cousin who is a naturopathic doctor agreed to be a birth companion, to serve as a kind of doula, providing massage and acupuncture during labor.

But, as they say, no battle plan ever survives contact with the enemy.  In the end, I had a labor and delivery that involved almost every kind of intervention, save a cesarean section, and I was one contraction away from being wheeled to the OR.

All this, in spite of delivering Portland, Oregon, one of the most progressive birth friendly places in the country, where standard labor, delivery, and postpartum practices aim to return to the “wisdom of the body,” rather than to operate at the convenience of the doctors or to clear out hospital beds as quickly as possible.

I delivered at Providence Portland Medical Center which is in the process of being certified as a prestigious “baby friendly” hospital by the Baby Friendly Hospital Initiative, (a program launched by the World Health Organization and UNICEF to recognize hospitals and birthing centers that offer the optimal care and support in mother/baby bonding and breastfeeding).  My doctor was general practitioner recommended by a friend, who told me in our first appointment that she tends to take a non-interventionist approach whenever safely possible. Plus, she said that in her ten years of delivering babies, she had only ever done two episiotomies.

And yet, for all the preparations and precautions, the earnest faith in my body and my own iron will, the perineal massage, (ya know, to try and stretch things out down there as much as possible ahead of time), things did not go according to plan.

My water broke at the very beginning of labor, at 2:30 in the morning, which in effect started a countdown clock. Medical practices aim to deliver a baby within twenty-four hours of a women’s broken water because that sack of amniotic fluid that serves as a barrier to bacteria; every hour that passes before delivery increases the risk of infection to both mother and baby.

So when my husband, my cousin, and I checked into the hospital with fast and furious contractions, I was admitted, despite the fact that I was only two centimeters dilated rather than the five that is typically accepted.

But, for whatever reason, once we made it to the labor room, my body slowed way down, with contractions now only every fifteen to twenty minutes, despite my best efforts to get labor moving by walking the halls, hot showers, and even a little Michael Jackson dance party, inspired by that viral video of the woman doing the Tootsie Roll during her labor. By 4:00 pm, though, my doctor said that we had to get things progressing, so she ordered that we start Pitocin, a synthetic version of oxytocin, the hormone that signals the uterus to contract. So much for my unmedicated labor.

But, it worked. They put me on a very low dose of Pitocin and, as they slowly increased it over the next few hours, so did the contractions. Although I could no longer walk around without being attached to a machine, I was still standing, rocking, sitting on a birthing ball, as my husband and cousin took turns rubbing my back and holding my hands, and by 6:30 pm, I was six centimeters dilated. Only four more to go until the fully dilated ten centimeters. At 8:00 pm they checked me again when attaching an internal fetal monitor—because the external one I was wearing around my belly kept slipping off—and I was eight centimeters. My doctor said that it should only be a matter of time and to let the nurses know when I felt a strong desire to push.

So, I kept standing, rocking, moaning, and breathing through the most intense pain of my life. At hour twenty-two of active labor, my legs were starting to quiver from exhaustion, and I was beginning to wonder how I would make it through transition and pushing when I could barely stand. At midnight, my doctor returned and checked my cervix again with the heartbreaking news that I was still only eight centimeters dilated.

In my birth plan, I stated that I didn’t want to be offered pain medication. If I wanted it, I would ask for it, so I wouldn’t feel pressured into taking something I didn’t really want. But once my doctor told me that this stage of labor should take around two, maybe three hours, rather than the four I had already endured, and that we’d have to increase the Pitocin, I saw in her eyes that something had to be done. I knew I wouldn’t have enough energy to push when it came time.

I agreed to an epidural.

A few excruciating minutes later, the Magical Epidural Man entered the room, and performed some miraculous, wonderful wizardry on my spine. I immediately felt the lower half of my body go numb and, no exaggeration, a minute later, I was asleep.

Two hours after that, my doctor and nurses came into the room and told me that I had fully dilated and it was time to push. Sometimes the body just needs to relax, my doctor said. I was very grateful for modern medicine, in that moment.

We were getting close now. In theory, pushing is the big finale. So I pushed. And pushed. And pushed. This stage of labor typically takes any where between five minutes and two hours, but after two hours had passed, and the baby was still not coming down, my doctor asked for an OB, who determined that she was posterior facing, with the back of her skull against the back of my pelvis. She was backwards. He needed to reach in and corkscrew her 180 degrees.

After another hour of pushing and rotating, my face now covered in an oxygen mask, he was only able to get her halfway there. He started talking to me about options: forceps… vacuum…cesarean... “I really don’t want a c-section,” I pleaded. “I’ll push for as long as it takes.”

After some raised eyebrows and glances exchanged between the doctors and nurses, he turned me on my side and let me rest for half and hour in the hopes that gravity would do the rest. It worked. My baby was now facing the right direction, but after another forty-five minutes of pushing, she still had not come down.

Now, twenty-nine hours after my labor began, it was time for the morning shift change at the hospital. Another OB and nurse came in, and after assessing the situation, she determined that a vacuum assist was needed. This is essentially a little suction cup that gets attached to the baby’s head to help pull her out. Intervention number, what are we up to now? Pitocin, epidural, fetal monitor, manual rotation, vacuum…

The new OB warned me: you only get a few tugs with the vacuum, three or four contractions worth, and if it the baby is not out by then, we’d have to go to the OR for a c-section. Going on hour six of pushing, I craned my neck and bore down with all the strength I could muster. I started to run a fever.

Finally, the OB said, “You’re almost there! Reach down and feel your baby’s head.” I reached between my legs and my fingers grazed the warm, round mass. I started to cry. “Just a few more pushes!”

And then, slick and quivering, she burst into the world.

I didn’t know it at the time, thanks to the epidural, but with that last push the OB deftly snipped my perineum to make room for my baby’s shoulder, which would not have fit otherwise. Yep, the cherry on top of the layered intervention cake: an episiotomy.

This head back, eyes-closed repose is not from blissful relaxation. It is because I literally could not hold up my head after six hours of hunching and pushing.

As difficult as the labor was for me, I think it was worse for my baby, who emerged with an elongated head, a big purple welt from the vacuum seal, and a raw patch of missing skin from the manual rotation. The pain she must have felt prevented her from breastfeeding well for the first several days. Every time I brought her to my body to feed, she screamed so much that her lips turned a dusky purple, and by then we were both in tears.

We spent an extra night in the recovery room and then a night in the neonatal intensive care unit because my doctor was concerned about her dipping oxygen levels. We were visited by a few lactation specialists and the nurses helped us to try to get her to latch. In short, were both rather traumatized by the experience.

Childbirth is tough. There’s a reason that it is considered the punishment for Adam and Eve’s Biblical transgressions. In centuries past, my ancestors who screamed and squatted in fields and log cabins not only glowed in the bliss of maternal hormones, but also died prematurely of infection, eclampsia, blood loss, and obstructed labor, (which my labor would have certainly qualified as).

However, it is also the case that, in spite of the declining death rate of last 150 years, the childbirth mortality rate in the U.S. and Europe rose during the first half of the twentieth century. Although births had long been the purview of midwives, in the 1800s, undertrained and overeager male doctors started to participate in the increasingly lucrative business of labor and delivery. But almost immediately, childbirth mortality rates started to soar because, as this was before the theory of bacteria, these doctors had a habit of wandering directly from autopsies to deliveries without first washing their hands, and of overusing newfangled instruments and surgical practices.

Furthermore, as male doctors began to take over the birthing business, much of the knowledge of the midwives was lost. In her essay, "Coming to Understand: Orgasm and the Epistemology of Ignorance," philosopher Nancy Tuana points out that even though midwives and many doctors in other countries know how to turn a breech baby, for example, fear of malpractice litigation and business interests have directed medical practices in the U.S. toward c-sections.

Over the last century and a half, the wisdom of midwives and the wisdom of women’s bodies in the act of delivery has been undervalued and thereby lost—or rather, rendered silent—and replaced with medical interventions in a male dominated medical industry. Tuana calls this lack of knowledge about women’s health and bodies a manifestation of the “epistemology of ignorance.” Knowledge like this is not simply passively lost, but instead, “ignorance is frequently constructed and actively preserved, and is linked to issues of cognitive authority, doubt, trust, silencing, and uncertainty.”

There is a moment during my labor that I keep coming back to. During my six-hour stretch of pushing, I was lying flat on my back, feet in the stirrups, chin to my chest. This seemed to me like a very unnatural way to birth a baby, and definitely not the birthing position I had envisioned for myself.

At about hour two, I suggested that I get on my hands and knees, the way I had hoped to deliver, and a posture that would allow gravity to help the process. But I was told that because my lower half was numb due to the epidural, I had to stay on my back. I remembered the teacher of our birthing class saying that even with an epidural, it was possible to get on hands and knees if you moved slowly and had lots of support, but my doctor seemed so firm in saying no, and I was so exhausted, that I didn’t argue.

I wonder what would have happened if my husband, my cousin, or I had insisted. I wonder what would have happened if my doctor had trusted my instincts more. I heard afterward, (from another female doctor I struck up a conversation with at a restaurant, who had delivered over 700 babies), that when babies are turned the wrong direction, getting a woman on hands and knees usually gets them turned around. What if I could have avoided the manual rotation, the open sore on my baby’s head, the vacuum-incurred bruise, the weeks of breastfeeding difficulty, and the whiplash in my neck, just by a simple change in position that I had a gut feeling that we should do? Would a midwife have listened and trusted me more than my doctor did? Would having a certified doula in the room to advocate for me have allowed me to change position?

Since I became a mother, I’ve come learn that a mother’s intuition is a real thing. I seem to know when my baby is too hot or too cold, gassy or hungry, sick or sleepy, even though she can’t directly tell me these things. My breasts tingle minutes before she wakes up from a nap and wants to feed. There is a strange Spidey sense to the whole thing. It only makes sense, given that she grew and lived inside of me for the better part of a year. Why would we not think that this intuitive knowledge would begin during her labor, or even before? Why do we not trust a mother’s intuition during the birth of her baby?

Ending up with a labor and delivery so unlike the one I wanted meant that I had to grieve the loss of what I had hoped for. Not only that, but I had to somehow process and work through the trauma of all those interventions and the injury to both my daughter and me, while in the hormone surging, sleep deprived, foggy weeks of new motherhood.

In the end, I’m not sure if I should feel angry at the modern medical establishment for failing to value to the instincts and voices of women in labor—and thereby maybe unnecessarily causing avoidable injury to my baby and me—or grateful to it for providing the epidural that was able to move my labor along and possibly saved us from infection or even death. I have talked to so many women who have similar stories, and who don’t know how to feel about it.

Luckily, we do seem to be moving in the right direction as a country. More and more hospitals are trying to move away from interventions and starting to see mothers and their instincts as legitimate and valuable sources of knowledge during the labor process. In spite of the fact that I endured a lot of unwanted interventions, the doctors and nurses, (all of whom were female except the one OB and Magical Epidural Man) communicated with me clearly, deferred to me when possible, (except for that one moment during pushing), and included me as an active participant in my own labor.

My mother, who had a similar labor with me in the early 1980s, was given morphine without her knowledge or consent; my father was asked to sign off on it. And today’s practices are a vast improvement over those of the 1950s, when women checked into the hospitals, were essentially knocked unconscious, and then woke up with a swaddled baby in their arms.

But, unfortunately, I think my positive experience is the exception, rather than the norm, and is thanks to all of the work and research I did in trying to find the most baby friendly medical establishment I could. I’ve talked to many other women who say they felt pushed around and as though they totally lacked agency during their labors. In many parts of the country, a woman in labor is treated as a passive patient rather then a person with inherent wisdom. We still have a way to go in improving medical labor practices, and it requires trusting and valuing women’s intuitive knowledge of themselves and their bodies.

It turns out that the episiotomy wasn’t nearly as bad as I had feared. Because of the epidural, I didn’t even feel it happen, and my wound was stitched up and healed cleanly and quickly. And in the end, I have the most gorgeous baby girl who has brought incredible joy into my life. And, although I knew labor would be intense, I never really believed beyond the most remote possibility that she or I wouldn’t make it out alive. For that, I am grateful.

But I hope that, if my daughter chooses to have children a few decades from now and her birth doesn’t go according to plan, she will never have to wonder whether or not it was because her doctor values her wisdom.

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Danielle LaSusa Ph.D. is a Philosophical Coach and Consultant. She helps new moms grapple with what it means to make a person. She is the co-creater and co-host of Think Hard podcast, which brings fun, accessible, philosophical thinking to the real world.

The Wisdom of the Fire, or Why Philosophy Won’t Make You Happy

  Philosophy, the “love of wisdom,” can help us to live better, happier, and more fulfilling lives. As someone with a Ph.D. in philosophy, who has been reading and teaching philosophical texts on better living for over a decade, I have always wholeheartedly believed this claim—that is, until I went on a ten-day silent meditation retreat.

Before the retreat, I was convinced that deep, intellectual reflection and critical thinking about the aims and goals of life could lead me to a richly satisfying and genuinely happy existence—you know, that bit about the unexamined life. And, indeed, the lessons I’ve learned in the classroom have made a more thoughtful person, with a more coherent worldview, and a clearer story I can tell about who I am.

But, in the inevitable moments of depression or desperation that we all face, I found little solace in my books and intellectual commitments. Philosophy failed, even in traditions that are all about developing happiness, such as Buddhism, which teaches that minimizing desire will bring peace and contentment. For all of this reading and reflecting, I found that learning that I ought to want less didn’t make me feel any less desire. It just made me feel like a selfish, indulgent person, who should go look at more “life edit” blogs. In short, philosophy made me feel smart, but it didn’t make me feel happy.

After years of feeling dissatisfied and mildly depressed, I signed up for a 10-day retreat to study Vipassana meditation, (which means “to see reality as it is”). According to the course’s teacher, S. N. Goenka, Vipassana is the same technique that the Buddha himself used to become enlightened.

I was surprised to learn that students of this meditation course are asked to leave all reading and writing materials at home. What? No journal? How was I supposed to reflect, process, and work through my spiritual awakening? How would I remember what I’d learned? If not sitting contemplatively in the forest and writing, what would I be doing all day?

Turns out, I would be doing a lot of sitting—sitting very still. The strict schedule at the meditation center required that all students gather in the meditation hall for one-hour-long sessions of sitting quietly, three times a day. This may sound about as interesting as reading Hegel, but the kicker is that during these one-hour sessions, students are also asked to make a strong determination not to change postures. Don’t shift, don’t stretch, don’t move. “Don’t open your eyes, your hands, or your legs.”

Oh.

The technique takes as its foundation the awareness of the body’s sensations—without reacting to them. Sitting silently, bringing my attention through every part of my body from head to feet, without shifting around in my seat was, at times as tedious as it sounds, but more often, it felt like sitting on a bed of hot coals. When a twinge in my hip slowly built to a pulsing pain, and then a searing, screaming fire, it awakened all my of mind’s habitual desires to escape, to adjust, to fix it so that the pain goes away. It put to the test my ability to, as Goenka says, accept reality as it is, and not as I would like it to be.

Now this was learning to diminish desire. Put myself in a situation in which I want something, (i.e that burning in my muscles to go away), really, really badly, and very immediately, and just sit in the center of the fire.

I had to tell myself over and over that is was just pain, that I was not going to die, (although one time I did actually feel like I might), and to keep, as calmly as I could, bringing my attention slowly from head to foot and back again. I discovered that, when the mind stops resisting the pain, eventually the body relaxes, and the pain subsides.

Through this experience, I learned much more than I ever could have in reading a book about meditation. For one, I learned that I am capable of enduring much more than I thought. I sat with excruciatingly severe pain, not moving, and trying to talk myself into staying composed as sweat beaded on my forehead. Granted, several times after a particularly hard session, I ran to my room and sobbed for 30 minutes, but I also felt like I had let something go—an old pain that I’d been carrying around for a long time.

I saw a glimpse of the same thing I had read in those books—that indeed, all things are temporary, even if it feels like a pain that will last forever and swallow you whole.

I learned too, that when I stopped reacting so much and could be equanimous with the sensations of my pain and pleasure, (well, not so much pleasure and just relief when the pain subsided) my capability to see and observe things increased.

I’d read plenty of philosophical texts about how we acquire knowledge, but I had never experienced a lesson in perception like this before. After a week of meditating, I literally noticed things I hadn’t days earlier—I would go out walking on the same forest footpath and hear moles rustling under the leaves, see tufts of tiny mushrooms, smell the musk of wet moss. As my reactivity and my obsession with my own thoughts decreased, my senses heightened.

I learned to be more present, more mindful, more focused, and I started to feel moments of, dare I say, deep peace and contentment.

I learned that knowing something from reading or hearing about it is one thing and knowing it through experience is entirely different—one is intellect, the other is wisdom. And there are certain things that the intellect alone can never know. For someone who has never smelled cinnamon, reading about it will only leave a confused and vague impression. Indeed, reading the Dhamma Sutra or latest issue of Yoga Journal, or spending a dozen years buried in books only got me so far.

I had to go sit in the fire.

The Politics of Bathroom Changing Tables

When my daughter was about a month old, my husband and I took her to a restaurant for the first time. We were very proud of ourselves for making it out of the house and into the world with an infant. When you’re a new parent, the world looks different than it did before.

My husband and I are what you might consider a “modern couple.” We share in the parenting duties, at least as much uneven family leave will allow. He had to return to work two weeks after our daughter was born, leaving me home alone with her most of the day. But, when he’s home, in the evenings and weekends, he’s often is the one to change her diaper, figuring it’s the least he can do, given that I breastfeed her every two hours and haven’t had an uninterrupted night of sleep since she was born.

So, when we arrived at the restaurant, a kitschy independent barbecue joint, and knew she needed a diaper change — as evidenced by the concentrated grunting and telltale sounds of a diaper being filled — my husband grabbed her and headed to the bathroom.

I was relieved to have a few precious moments alone. I took off my sweater feeling sweaty and overheated. I wasn’t sure if it was because of the cashmere I was wearing or my fluctuating postpartum hormones. I downed the glass of ice water at the table, perpetually thirsty from constant breastfeeding, and picked up the menu to see what kind of barbecue would satisfy my iron-deficiency cravings.

But, before I could even scan past the appetizers, he returned saying that the men’s room didn’t have a changing table. He shrugged with a sorry look and handed the baby to me. “You want to see if the women’s room has one?” I sighed and scooted my right way out of the booth, slung the diaper bag over my shoulder, and headed to the ladies’ room. There was the changing table.

Before I had a kid, I barely even noticed things like changing tables. I know now that most public women’s rooms have one. But, many men’s don’t. When we’re out together in public, I’ve started changing our daughter just as a default, because we’ve had enough thwarted attempts for my husband to do it. I’ve now started to ask him when he returns from a public men’s bathroom if there was a changing table inside.

That’s is the thing about experience. New experiences inform you about some aspect of the world that you were blind to before. And you often don’t pay attention to the politics of how this world around you is constructed until you need to engage with it in a certain way. The fact that I now have been tasked with public diaper changing means that I really pay attention to where changing tables are located. 

And this is an aspect of the world that is, frankly, sexist. It both reflects and perpetuates the dominant care-taking gender roles: women change diapers, men don’t. My husband couldn’t change a dirty diaper in that restaurant even if he wanted to, unless he went into the women’s room or changed our daughter’s poop-filled diaper on the dining table.

I’ve started to think that second option would be the appropriate move. If the restaurant staff or any of the other patrons complained about the smell, we would have to kindly explain that my husband is the one who changes the diapers, but that this restaurant didn’t provide a changing table in the men’s room. 

Maybe by saying these things out loud, rather than enduring them quietly, by calling attention to a structural failing in the way our world is organized to those folks who don’t usually pay attention, we can start to change more than just dirty diapers.

The world is better because this poem by e.e. cummings exists

  i thank You God for most this amazing

day: for the leaping greenly spirits of trees and a blue true dream of sky; and for everything which is natural which is infinite which is yes

(i who have died am alive again today, and this is the sun’s birthday; this is the birth day of life and of love and wings: and of the gay great happening illimitably earth)

how should tasting touching hearing seeing breathing any–lifted from the no of all nothing–human merely being doubt unimaginable You?

(now the ears of my ears awake and now the eyes of my eyes are opened)

e.e. cummings